Provider Demographics
NPI:1508574526
Name:MCCOLL, NAOMI LYNN (MSC CPC-I)
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:LYNN
Last Name:MCCOLL
Suffix:
Gender:F
Credentials:MSC CPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2794 FOXHILL DR
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-4334
Mailing Address - Country:US
Mailing Address - Phone:775-721-8409
Mailing Address - Fax:
Practice Address - Street 1:755 N ROOP ST STE 101
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89701-3107
Practice Address - Country:US
Practice Address - Phone:775-841-6050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCI5203101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional